Brandt Jan-M, MacDonald Steven J, Bourne Robert B, Medley John B
Concordia Hip and Knee Institute, Suite 310-1155 Concordia Ave., Winnipeg, MB, Canada R2K 2M9.
Knee. 2012 Aug;19(4):306-15. doi: 10.1016/j.knee.2011.06.007. Epub 2011 Jul 23.
Retrieved knee implants were examined to investigate the influence of patient and implant related factors on backside damage. Fifty-two implants of three different models were examined that all had cemented tibial trays without screw holes. A semi-quantitative grading system supplied backside damage scores (BDS) for each polyethylene (PE) tibial insert. Evidence was obtained to support the use of a constraining partial-peripheral locking mechanism and polished tibial tray surface (particularly for male patients) to reduce backside damage. Overall, male patients in the present study were associated with higher body mass and higher BDS compared with female patients. Furthermore, PE inserts sterilized by gamma-in-air had higher BDS than PE inserts sterilized in inert environments (gas-plasma or ethylene-oxide). Also, the proximal surfaces of tibial trays that had been grit-blasted showed embedded particles that may have increased backside damage. While none of these overall findings was unexpected, the present study provided detailed supporting analysis based on data from clinical retrievals, which may further support the use of a polished tibial tray combined with partial-peripheral locking mechanism to reduce BDS.
对取出的膝关节植入物进行检查，以研究患者和植入物相关因素对背面损伤的影响。检查了三种不同型号的52个植入物，这些植入物均为无螺孔的骨水泥固定胫骨托。一种半定量分级系统为每个聚乙烯（PE）胫骨衬垫提供了背面损伤评分（BDS）。有证据支持使用约束性部分周边锁定机制和抛光的胫骨托表面（特别是对于男性患者）来减少背面损伤。总体而言，本研究中的男性患者与女性患者相比，体重更高且BDS更高。此外，空气中伽马灭菌的PE衬垫比在惰性环境（气体等离子体或环氧乙烷）中灭菌的PE衬垫具有更高的BDS。而且，经过喷砂处理的胫骨托近端表面显示有嵌入颗粒，这可能增加了背面损伤。虽然这些总体发现都在意料之中，但本研究基于临床取出数据提供了详细的支持性分析，这可能进一步支持使用抛光胫骨托结合部分周边锁定机制来降低BDS。
